AmeriHealth

Medicare Enrollment Process Senior

Source: beBee S2

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at .

Responsibilities:

The enrollment lead is responsible for assisting with day-to-day operations of the enrollment team while ensuring that compliance standards are met. The enrollment lead will provide support to staff to ensure the enrollment process is in compliance, accurate and timely. The enrollment lead will identify and analyze system problems and provide solutions and/or recommendations as they relate to the enrollment process. He/she will assist in the development and/or implementation of policies and procedures for the enrollment department. The enrollment lead will assist and support the Enrollment Team including the Enrollment Manager and the Enrollment Director. This position plays an important role in building the team, encouraging team behavior and developing the staff. This role requires comprehensive knowledge of CMS rules and regulations, as well as internal processes, to completion of assignments. This position will provide assistance for curriculum writing, creation and maintenance of policy and procedure documents, work instructions, maintenance of facilitator and participant training guides and the proficiency model. The lead partners with the manager and various internal entities in multiple geographic locations to achieve the desired training outcomes. The lead is responsible for completing and tracking any special projects or reconciliations pertaining to the enrollment process, as well as, conducting root cause analysis and remediation for any and all enrollment escalations (i.e. CTM Complaints, Appeals, and Grievances, etc.). The enrollment lead will report directly to the enrollment manager and will support any and all other responsibilities as delegated.

Education/Experience:

  • High School/GED.
  • 1-3 years processor experience.
  • Knowledge of Medicare regulations, experience in Managed Care Enrollment (MA, MAPD and PDP).
  • Knowledge of CMS.
  • Knowledge of MMP Plans.
  • Microsoft Office- Excel, Access, Word, Outlook.
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2 days ago



Philadelphia, Pennsylvania

AmeriHealth

Full Time

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